2018-04-20 Senior Inspiration AwardsAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs I i
Division, Department, or Region (if applicable) ZO��
Uesignated Agency Contact (Name Title)
Christina Chartier, Executive Assistant to Mayor and Council
A Public Document
i= FA01 �.rik ...
20 AM g: C 1 1 For Official Use Only
L."FIC OF jj-�E CITY GLEE,.
❑ Amendment (Must Provide Explanah'on in Part 3.)
760-322-8366 1 Christina.Chartier@paimspdngsca.gov I Date of Original Filing:
(month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑ Face Value of Each TickettPass $ 30.00
Event Description` Senior Inspiration Awards Date(s) 04 / 20 / 18 1 1
Provide Titte/Explanation
Ticket(s)iPass(es) provided by agency? Yes ❑ No ® If no, Mizell Center
Name of source
Was ticket distribution made at the behest Yes ❑ No ® if yes:
Officials Name (task First)
of agency official?
3. Recipients
• Use Section A to identify the agency's department or unit. • Use Section B to identify an individuai. • Use Section c to identify an outside organization.
Number
A. Name of Agency, Department or Unit of Ticket(sy Describe the public purpose made pursuant to the agency's policy
Passes
Name of Individual Humber
B. of Tiekegsy Identify one of the following:
(Last, First) Passes
Robert Moon Ceremonial Role ❑ other ® Income ❑
1 OchecMng �ammonlalRda-w-Other-desatbebafaw
Public Purpose as defined by PS Resolution No. 22454
Section 1 d vii
Christy Holstege Ceremonial Role ❑ Other ® Income ❑
1 trcheckrng'centrnoniar Rok' or'Other dbsulbe below
Public Purpose as defined by PS Resolution No. 22454
Section 1 d vii
Name of Outside Organization Number
(include oddness and description) ofTicket(sy Describe the public purpose made pursuant to the agency's policy
Passes
4. Verification
! have read and understand FPPC egulations 18944 1 and 18942.1 have verified that the distribution set forth above, is in accordance
with the requirements
David Ready City Manager
.. Signature of AgeneajLo nee Print Name Title (month, day, year)
Comment:
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (3661275-3772)
Agency Report of:California
02
Ceremonial Role Events and Ticket/Pass Distributions '
Continuation Sheet A Public Document
Agency Name
City of Palm Springs
3. Recipients
• Use Section A to identify the agency's department or unit. - Use Section B to identify an individual. - Use Section C to identify an outside organization.
Nunbor
A. Name of Agency, Department or Unit
of TIcket(sY
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last F04
Number
of Ticket(s)l
Passes
identify one of the following:
Lisa Middleton
Ceremonial Role ❑ Other ® Income ❑
2
treheddng 'CedemanM! Rote' or'01her desobe NOW
Public Purpose as defined by PS Resolution No. 22454
Section 1(d)(vii)
Denise Goolsby
Ceremonial Role ❑ Other ® Income ❑
;
1
It drat Rde' or other describe below
Public Purpose as defined by PS Resolution No. 22454
Section 1 d vii
Suzanne Severin
Ceremonial Dole ❑ other ® Income ❑
1
Ncheddng •s"moniat Rde•or Vtherdeschbe balnw
Public Purpose as defined by PS Resolution No. 22454
Section 1 d vii
Boris Stark
Ceremonial Role ❑ Other ® Income ❑
1
It checwrg 'Ca+amo" Role' or'Otherdesedrbe below
Name of Outside Organization
C.
(include address and description)
Number
of Ticket(sy
Pam
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Heipllne: $S$lASK-FPPC (8881275-3772)
Form 802 —Additional Tickets for Senior Inspiration Awards 04/20/18
Charles Dunn —1, Public Purpose as described by PS Resolution No. 22454
Ken Behrens - 1, Public Purpose as described by PS Resolution No. 22454
Carl Stevenson —1, Public Purpose as described by PS Resolution No. 22454
Joe Granado —1, Public Purpose as described by PS Resolution No. 22454
Sharron Frey —1, Public Purpose as described by PS Resolution No. 22454
Bill Morhous —1, Public Purpose as described by PS Resolution No. 22454
Diane Ross-1, Public Purpose as described by PS Resolution No. 22454
Lyn Simonson —1, Public Purpose as described by PS Resolution No. 22454
Juanita Miller —1, Public Purpose as described by PS Resolution No. 22454
Judy Valone —1, Public Purpose as described by PS Resolution No. 22454
Vickie Moon —1, Public Purpose as described by PS Resolution No. 22454